- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.79 / $328.94 / $7,278.00
| Facility | | $136.79 | $328.94 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.24 / $1,359.55 / $2,702.90
| Facility | | $453.24 | $1,359.55 | $2,702.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136.79 / $243.00 / $375.07
| Facility | | $136.79 | $243.00 | $375.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.98 / $979.98 / $16,394.00
| Facility | | $979.98 | $979.98 | $16,394.00 |